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Surface flattening of the human left atrium and proof-of-concept clinical applications

Karim, Rashed; Ma, Ying Liang; Jang, Munjung; Housden, R. James; Williams, Steven E.; Chen, Zhong; Ataollahi, Asghar; Althoefer, Kaspar; Rinaldi, C. Aldo; Razavi, Reza; O'Neill, Mark D.; Schaeftter, Tobias; Rhode, Kawal S.


Rashed Karim

Ying Liang Ma

Munjung Jang

R. James Housden

Steven E. Williams

Zhong Chen

Asghar Ataollahi

Kaspar Althoefer

C. Aldo Rinaldi

Reza Razavi

Mark D. O'Neill

Tobias Schaeftter

Kawal S. Rhode


Surface flattening in medical imaging has seen widespread use in neurology and more recently in cardiology to describe the left ventricle using the bull's-eye plot. The method is particularly useful to standardize the display of functional information derived from medical imaging and catheter-based measurements. We hypothesized that a similar approach could be possible for the more complex shape of the left atrium (LA) and that the surface flattening could be useful for the management of patients with atrial fibrillation (AF). We implemented an existing surface mesh parameterization approach to flatten and unfold 3D LA models. Mapping errors going from 2D to 3D and the inverse were investigated both qualitatively and quantitatively using synthetic data of regular shapes and computer tomography scans of an anthropomorphic phantom. Testing of the approach was carried out using data from 14 patients undergoing ablation treatment for AF. 3D LA meshes were obtained from magnetic resonance imaging and electroanatomical mapping systems. These were unfolded using the developed approach and used to demonstrate proof-of-concept applications, such as the display of scar information, electrical information and catheter position. The work carried out shows that the unfolding of complex cardiac structures, such as the LA, is feasible and has several potential clinical uses for the management of patients with AF. © 2014 The Authors.


Karim, R., Ma, Y. L., Jang, M., Housden, R. J., Williams, S. E., Chen, Z., …Rhode, K. S. (2014). Surface flattening of the human left atrium and proof-of-concept clinical applications. Computerized Medical Imaging and Graphics, 38(4), 251-266.

Journal Article Type Article
Publication Date Jan 1, 2014
Journal Computerized Medical Imaging and Graphics
Print ISSN 0895-6111
Electronic ISSN 1879-0771
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 38
Issue 4
Pages 251-266
Keywords left atrial surface parameterization, lesion visualization, surface flattening, catheter ablation planning and navigation, atrial fibrillation
Public URL
Publisher URL
Additional Information Corporate Creators : King's College London, University of the West of England, St Thomas Hospital


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